血栓弹力图和常规凝血检测在不同类型冠心病患者中的应用价值

Application value of thromboelastogram and routine coagulation test in patients with different types of coronary heart disease

目的:观察血栓弹力图和常规凝血检测在不同类型冠心病患者中的应用价值。方法:回顾性分析2018年1月至2019年6月沈阳市第四人民医院收治的95例冠心病患者的临床资料。根据患者冠心病分型不同将其分为急性心肌梗死组32例,不稳定性心绞痛组33例和稳定性心绞痛组30例,另选取同期在沈阳市第四人民医院体检中心行体检的31名健康者设为对照组,四组均进行凝血项目检测,并比较TEG指标水平和常规凝血指标水平。结果:与对照组比较,急性心肌梗死组、不稳定性心绞痛组、稳定性心绞痛组凝血反应时间、血细胞凝集块形成时间及凝血酶原时间缩短,血凝块最大强度、角度增加,纤维蛋白原水平升高,急性心肌梗死组和不稳定性心绞痛组部分凝血活酶时间缩短,差异均有统计学意义(P<0.05);与稳定性心绞痛组比较,急性心肌梗死组、不稳定性心绞痛组凝血反应时间、血细胞凝集块形成时间及部分凝血活酶时间缩短,血凝块最大强度及角度增加,纤维蛋白原水平增高,不稳定性心绞痛组血小板计数水平升高,差异均有统计学意义(P<0.05);与不稳定性心绞痛组比较,急性心肌梗死组部分凝血活酶时间缩短,纤维蛋白原水平增高,差异均有统计学意义(P<0.05);急性心肌梗死组和不稳定性心绞痛组各TEG指标水平及凝血酶原时间、PLT水平比较,差异均无统计学意义(P>0.05)。结论:不同类型冠心病患者的血栓弹力图检测和常规凝血检测水平存在差异,可为临床诊治及预后提供参考。

Objective:To explore application value of thromboelastogram and routine coagulation test in patients with different types of coronary heart disease.Methods:A retrospective analysis of the clinical data of 95 patients with coronary heart disease from January 2018 to June 2019 was performed.According to the different types of coronary heart disease,they were divided into acute myocardial infarction group(32 cases),unstable angina group(33 cases)and stable angina group(30 cases).In addition,31 healthy people who underwent physical examinations at the physical examination center of the 4th People’s Hospital of Shenyang during the same period were set as control groups.All four groups were given coagulation test.The levels of TEG indicators and routine coagulation indicators of the four groups were compared.Results:Compared with the control group,the coagulation reaction time,hemagglutination time and prothrombin time of the acute myocardial infarction group,the unstable angina pectoris group,and the stable angina pectoris group were shortened,and the maximum strength and angle of blood clot and the fibrinogen levels increased;the partial thromboplastin times were shortened in the acute myocardial infarction group and the unstable angina pectoris group;and the differences were statistically significant(P<0.05).Compared with the stable angina pectoris group,the acute myocardial infarction group and the unstable angina pectoris group had the shorter coagulation reaction time,hemagglutination time and partial thromboplastin time,increased maximum clot strength and angle,and increased fibrinogen levels;the platelet count level of the unstable angina group increased;and the differences were statistically significant(P<0.05).Compared with the unstable angina pectoris group,the acute myocardial infarction group had the shorter partial thromboplastin time and increased fibrinogen level,and the differences were statistically significant(P<0.05).However,there were no significant differences in the levels of TEG indicators,prothrombin time and PLT level between the acute myocardial infarction group and the unstable angina group(P>0.05).Conclusions:There are differences in the levels of thrombelastogram and routine coagulation test in the patients with different types of coronary heart disease,which can provide references for clinical diagnosis,treatment and prognosis.